Method of implanting a hearing aid

ABSTRACT

A method is described of implanting a hearing improvement device within the human body, in which a postauricular incision is made in the skin of the anatomical area behind the auricular appendage of the external ear, to thereby expose the bony structure overlying the body of the mastoid, removing a predetermined area of bone down to the antrum cell of the mastoid, implanting the device in the cavity formed, and then closing the incision. The device has a portion which extends into the middle ear space.

United States Patent [72] Inventor Jack Lawrence Mahoney Carmel, Calif.(90] Pacific St., Monterey, Calif., 93940) [21] Appl. No. 663,603

Filed Aug. 28, 1967 Division of 338,858, Dec. 27, 1963, Patent No.3,346,704. [45] Patented Jan. 26, 1971 [54] METHOD OF IMPLANTING AHEARING AID 5 Claims, 3 Drawing Figs.

[52] U.S.Cl 128/1, 179/107 [51] Int. Cl A6lf 11/04, H04r 25/00 [50]Field of Search 128/1,2,

2.1; 179/l07(all); 181/23 [56] References Cited UNITED STATES PATENTS2,641,328 6/1953 Beaudry 181/23 2,967,913 [/1961 Aubert et al 179/107(E)3,170,046 2/1965 Leale 179/107(E) 2,611,829 9/1952 Hazard 179/107(BC)3,209,081 9/1965 Ducote et a1. 179/107(BC) Primary Examiner-Richard C.Pinkham Assistant Examiner-Paul E. Shapiro Att0rneylsler and QmsteinABSTRACT: A method is described of implanting a hearing improvementdevice within the human body, in which a postauricular incision is madein the skin of the anatomical area behind the auricular appendage of theexternal ear, to thereby expose the bony structure overlying the body ofthe mastoid, removing a predetermined area of bone down to the antrumcell of the mastoid, implanting the device in the cavity formed, andthen closing the incision. The device has a portion which extends intothe middle ear space.

PATENTEDJANZBIQYI 3557.775

SHEET 1 [IF 2 JMCROPHONE TUBE -AMPLIFIER UNIT INVENTOR.

JACK L. MAHONEY LLC H ATTORNEYS PATENIEflJAnzslsn I $557,775

SHEET 2 OF 2 SKIN (POSTERIOR TO AURICLE) MICROPHONE TUBE (ll) AMPLIFIERUNIT (IOI SPEAKER TUBE (IZI MIDDLE EAR CAVITY ROUND WINDOW DUCT TOCOCHLEA I NVEN TOR.

F/'g 3 JACK L. mmousv M ram ATTORNEYS METHOD OF IMPLANTING AHEARING AIDThis application is a division of my copending application, Ser. No.333,858, filed Dec. 27, 1963, for MEANS FOR AID- ING HEARING and sincematured into Pat. No. 3,364,704.

This invention relates generally to a method of implanting a hearing aidin the human body, but has reference more particularly to a method inwhich the hearing aid is so implanted as to be completely enclosedwithin the head of the individual utilizing the hearing aid.

Hearing aids which are presently available on the market are usuallyworn outside of the body, and are therefore objectionable from anesthetic, cosmetic or functional viewpoint.

Although attempts have been made to utilize such hearing aids in amanner to conceal them from view, as, for example, within the temples ofspectacles, it is'virtually impossible to conceal certain portions ofthe hearing aid, such as wires, etc., and fort for this reason, manypersons whose hearing facilities can be improved do not avail themselvesof such aids.

The present invention has as its primary object the provision of amethod whereby an audio implant in the nature of a miniaturized systemfor amplifying sound, is placed directly in the structure of the ear andutilizes the impaired or-damaged, but still functioning, normal channelsfor transmission of sound to the brain.

Another object of the invention is to provide a method wherein animplant of the character described, is disposed in its entirety withinthe head structure of the user, and is entirely concealed from view,thereby eliminating any and all objections to its use from an estheticor cosmetic point of view.

A further object of the invention is to provide a method wherein theimplant utilizes a battery which is enclosed within the head structure.

Other objects and advantages of the invention willbecome apparent in thecourse of the following'description, taken in conjunction with theaccompanying drawings wherein:

FIG. I is a vertical cross-sectional view of aportion of a human headtaken through theright side of the head. and

passing through the mastoid antrum and middle ear in a plane parallel toa plane passing through the nose and the back of the head, and showingthe components of the audio implant of the present inventionin'position;

FIG. 2 is a fragmentary elevational view showing a portion of the rightside of the head, and with theexternal ear pulled forwardly to show orindicate where the implant and microphone tube are placed; and

FIG. 3 is a tabulation of the means utilizing the implantiof the presentinvention, whereby sound is transmitted tothe temporal lobe of thebrain, where the sound is heard.

Referring more particularly to the drawings,-an understand ing of FIG. 1can be gained if the observer can imagine he is inside the head of theperson depicted in FIG. '1, and is looking outwardly and through theright ear.

The observer will see the auditory canal l, thetympanic membrane 2, themalleus 3, theincus 4. and themastoid antrum 5. The tip of the mastoidis' indicated by reference numeral 6, the chorda tympani by referencenumeral 7, a facial nerve by reference numeral 8 and thesquama byreference numeral 9.

Normal hearing in an individual is accomplished by the help i of theexternal car, which concentrates'thesonorous vibrations of the air uponthe tympanic membrane,--causing the latter to vibrate. The chain ofbones in the middleeannamely the malleus, incus and stapes,transmitsthese vibrations to the internal ear, where, wholly or chieflythrough the hair cells in t the organ of corti, they stimulate thefibers of theauditory nerve, which then carries the sound impulses tothe temporal lobe of the brain.

In accordance with my invention, I provide axhearing improvement devicewhich Iterm an audio implant," and which consists of several components,including mainly a microphone, a battery, an amplifying system and aspeaker,

such as are found in a conventional hearing aidhThese-components areencased in a silicone rubber sponge. with a hardened coat of siliconerubber to form a unit, designated by reference numeral 10 in FIGS. 1 and2.

The unit 10 is rectangular in shape, measuring approximately l cm. X lc'm., and a few millimeters in thickness, and is provided with asilicone rubber tube 11 extending centrally from one en'd'of the unit10, and a similar tube '12 extending centrally from one side of the unit10. The tubes 11 and 12 are approximately IV: cm. in length, andapproximately 2 mm. in diameter. The tube 11, which I term themicrophone tube, is attached to the microphone within the unit 10, andboth ends of the tube are sealed with a very thin membrane of siliconerubber. The tube 12, which I term the speaker tube, is attached to thespeaker within the unit 10, and both ends of this tube are sealed with avery thin membrane of silicone rubber.

When the device is to be implanted, a postauricular incision is madeadjacent the auricular appendage of the external ear, in the skin of theanatomical area of the ear. This incision is approximately threecentimeters in length, and is carried out under local anesthesia. Thebony structure overlying the body of the mastoid is exposed, and an areaof bone, i.e., an area of approximately 2 square centimeters, is removeddown to the antrum cell of the mastoid. A few of the air cells of themastoid are then removed to enlarge the antrum cell to accommodate theunit 10.

The unit 10 is then placed directly into this space in the manner shownin FIG. I, and the speaker tube 12 is then placed in a passageway whichextends from the antrum cell of the mastoid into the middle'ear spacebehind the ear drum. More specifically, the speaker tube is brought upthrough a small opening near the introitus of the ear canal, and to apoint closely adjacent to what is commonly referred to as the ""roundwindow The wave motion is transmitted to the cochlea, which startstheelectrical impulses to the temporal lobe'of the brain.

The microphone'tube '11 is then extended externally from -"the'ant'rumcell of the mastoid and is covered with skin and i will be disposed justbeneath the skin behind the ear. The incision is th'en closed, and theear again completely sealed. Since the'skin inc'isio'nis made in ahidden area adjacent the car, no noticeable scar will be produced, afterhealing.

Referring to FIG. 3 of the drawing, it is seen that through theuseof thehearingaid of this invention, sound vibrations aretransmit'ted throughthe skin, posterior to the auricle, hence to themicrophone tube 11,amplifier unit 10, speaker tube 12,-middle ear cavity, round window, andduct to choclea, thence in the normal manner to the temporal lobe of thebrain.

'I'he'batterywithin the unit l0 is preferably a silver-cadmiumbattery'and'ca'n becharged by a magnetic induction coil which isattaehedto a head-band, which can be worn on the head while sleeping, orat anyother time which is convenient. The induction coil is connected toa wire which leads to a transistorized charging'unit'which is energizedfrom a conventional electrical outlet'ln charging the battery, theinduction coil'onthehead'band' is placed directly over the mainstructure of the mastoid.

The implant' will function for approximately eight days before itbecomes necessary to recharge such a battery with the magnetic inductioncoilf'Recharging of the battery requires approximately 6 hours.

One of theadvant'ages of the use of such an implant is that it isembeddedsolidly in the bone of the skull, and is so situated thatit'c'an' drive' the sound directly into the inner car, without thenecessity" of driving the's'ound'through the'tympanic mem brane, whichoffers considerable resistance to transmission of sound in cases ofconductive deafness where the oval window and'stapesarefused by abnormalbone closure called otosclerosis.

Another advantage is that there are no parts which aredisposed-externally of the head'or are'visible, so' that objec tions touse ofthe device, based on psychological factors, andcosmet'i'c'view'points'are eliminated.

A further advantage lies in the fact that the replacement batteries, anditsattendant costs, are eliminated.

A still further advantage resides in the elimination of the rushingandclothing noise which is a constant source of annoyance to individualsfrom movement across the microphones of hearing aids which are carriedabout the body.

The device is also of particular advantage for children who require theuse of a hearing aid to hear sufficiently to carry on their school work,while finding it necessary to remove these aids during play and physicalactivity since external hearing aids and devices are easily dislodged orbroken during such play or physical activity.

It is thus seen that l have provided a means of aiding hearing ofindividuals whose hearing is. not remediable medically or surgically,but who require amplification of sound for hearing.

it is also seen that l have provided an audio implant in the nature of aminiaturized system for amplifying sound, which is placed directly inthe structure of the ear and utilizes the impaired or damaged, but stillfunctional, normal channels for transmission of sound to the brain.

It is'further seen that l have provided an implant which is disposed inits entirety within the head structure of the user, and is entirelyconcealed from view, thereby eliminating any and all objections to itsuse from an esthetic or cosmetic point of view.

It will be understood that various changes may be made in the details ofthe invention, as described, without departing from the spirit of theinvention, or the scope of the appended claims.

Iclaim:

l. The method of implanting a self-contained hearing improvement devicewithin the human body, in which said device contains a microphone, abattery, an amplifying system, which is neutral to the adjacent portionsof the body, a microphone tube extending from the microphone in saidunit; a speaker and a speaker tube extending therefrom including thesteps of making an incision adjacent the auricular appendage of theexternal ear, in the skin'of the anotomical area of the ear, exposingthe bony structure overlying the body of the mastoid, removing apredetermined area of bone down to the antrum cell of the mastoid,implanting the self-contained hearing improvement device in said antrumcell, situating an outer end of the microphone tube into position andadjacent the skin behind the auricular appendage and situating an outerend of said speaker tube into the middle ear space behind the ear drumthrough the antrum-inner ear passage; and thereafter closing theincision.

2. The method of implanting in the human body a hearing improvementdevice including signal-receiving means for receiving an incoming signalrepresentative of a sound wave existing outside of the human body,intermediate means for converting said incoming signal to anaudiofrequency electrical signal, output means includingelectrical-mechanical transducer means to generate mechanical motionfrom said electrical signal, an operative connection between saidsignal-receiving means, said intermediate means and between saidintermediate means and said output means, said method comprising thesteps of.making an incision in the skin in the auricular area of the earadjacent the auricular appendage of the external ear; exposing the bonystructure overlying the body of the mastoid; removing an area of bonystructure to expose the an trum cell cavity; positioning said hearingimprovement device within said cavity and with at least part of saidoutput means in the middle ear space to deliver said generatedmechanical motion directly thereinto; and then closing the incision.

3. The method specified in claim 2 and the step'of removing sufficientair cells of the mastoid to enlarge the antrum cell cavity toaccommodate the implanting of said hearing improvement device, said stepbeing performed before the step of positioning said output means.

4. The method of implanting a hearing improvement device in a humanbody, said device including signal-receiving means for receiving anincoming signal representative of a sound wave existing outside of saidhuman body, intermediate means for converting said incoming signal to anaudiofrequency electrical signal, output means includingelectrical-mechanical transducer means adapted to generate mechanicalmotion from the electrical signal, and operative connections from saidsignal-receiving means to said intermediate means and from theintermediate means to the output means; said method comprising the stepsof surgically positioning at least a portion of said output means withinthe human body in the middle ear space at the round window to permitsaid generated mechanical motion to pass from said output means directlyto the middle ear space behind the area of the tympanic membrane;concurrently positioning said signal-receiving means within the humanbody in position to receive said incoming signal; and further,surgically positioning said intermediate means within the human body ata locus removed from the middle ear space but adjacent the area of theauricular appendage of the ear and in operative relationship to saidsignal-receiving means and said output means.

5. The method of implanting a hearing improvement device within thehuman body, said method comprising the steps of: making an incisionadjacent the auricular appendage of the external ear in the skin of theanatomical area of the ear; exposing the bony structure overlying thebody of the mastoid; removing a predetermined area of bone down to theantrum cell of the mastoid; implanting a hearing improvement device inthe cavity formed by the bone removal and mastoid antrum cell with atleast a portion of the device extending into the middle ear space; andclosing the incision.

1. The method of implanting a self-contained hearing improvement devicewithin the human body, in which said device contains a microphone, abattery, an amplifying system, which is neutral to the adjacent portionsof the body, a microphone tube extending from the microphone in saidunit; a speaker and a speaker tube extending therefrom including thesteps of making an incision adjacent the auricular appendage of theexternal ear, in the skin of the anotomical area of the ear, exposingthe bony structure overlying the body of the mastoid, removing apredetermined area of bone down to the antrum cell of the mastoid,implanting the self-contained hearing improvement device in said antrumcell, situating an outer end of the microphone tube into position andadjacent the skin behind the auricular appendage and situating an outerend of said speaker tube into the middle ear space behind the ear drumthrough the antrum-inner ear passage; and thereafter closing theincision.
 2. The method Of implanting in the human body a hearingimprovement device including signal-receiving means for receiving anincoming signal representative of a sound wave existing outside of thehuman body, intermediate means for converting said incoming signal to anaudiofrequency electrical signal, output means includingelectrical-mechanical transducer means to generate mechanical motionfrom said electrical signal, an operative connection between saidsignal-receiving means, said intermediate means and between saidintermediate means and said output means, said method comprising thesteps of making an incision in the skin in the auricular area of the earadjacent the auricular appendage of the external ear; exposing the bonystructure overlying the body of the mastoid; removing an area of bonystructure to expose the antrum cell cavity; positioning said hearingimprovement device within said cavity and with at least part of saidoutput means in the middle ear space to deliver said generatedmechanical motion directly thereinto; and then closing the incision. 3.The method specified in claim 2 and the step of removing sufficient aircells of the mastoid to enlarge the antrum cell cavity to accommodatethe implanting of said hearing improvement device, said step beingperformed before the step of positioning said output means.
 4. Themethod of implanting a hearing improvement device in a human body, saiddevice including signal-receiving means for receiving an incoming signalrepresentative of a sound wave existing outside of said human body,intermediate means for converting said incoming signal to anaudiofrequency electrical signal, output means includingelectrical-mechanical transducer means adapted to generate mechanicalmotion from the electrical signal, and operative connections from saidsignal-receiving means to said intermediate means and from theintermediate means to the output means; said method comprising the stepsof surgically positioning at least a portion of said output means withinthe human body in the middle ear space at the round window to permitsaid generated mechanical motion to pass from said output means directlyto the middle ear space behind the area of the tympanic membrane;concurrently positioning said signal-receiving means within the humanbody in position to receive said incoming signal; and further,surgically positioning said intermediate means within the human body ata locus removed from the middle ear space but adjacent the area of theauricular appendage of the ear and in operative relationship to saidsignal-receiving means and said output means.
 5. The method ofimplanting a hearing improvement device within the human body, saidmethod comprising the steps of: making an incision adjacent theauricular appendage of the external ear in the skin of the anatomicalarea of the ear; exposing the bony structure overlying the body of themastoid; removing a predetermined area of bone down to the antrum cellof the mastoid; implanting a hearing improvement device in the cavityformed by the bone removal and mastoid antrum cell with at least aportion of the device extending into the middle ear space; and closingthe incision.